The lipid accumulation product is a powerful tool to predict metabolic syndrome in undiagnosed Brazilian adults

Background & aims: Lipid accumulation product (LAP) is emergent predictor of central lipid accumulation linked to diabetes risk and cardiovascular disease. In this study, our aims were (i) to assess the accuracy of the LAP for predicting metabolic syndrome (MS) in subjects without diagnosis of cardiovascular disease (CVD) and type 2 diabetes mellitus compared with other classical anthropometric parameters and (ii) to estimate the optimal LAP cut-off point to predict MS in this population. Subjects/Methods: We conducted a cross-sectional study with representative undiagnosed subjects aged 20-79 years (n = 201; 37.8% men), selected by Simple random sampling. In this study, subjects without previous diagnosis of CVD and type 2 diabetes mellitus, and those who did not make use of continuous medication were included. The independent variables were body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) and LAP. MS was defined by American Heart Association and the National Heart, Lung, and Blood Institute (AHA/NHLBI); International Diabetes Federation (IDF); and a harmonized criteria between AHA/NHLBI and IDF. Results: The prevalence of MS was 78.9% and 69.6% for men and women, respectively. LAP showed better area under the curve (AUC) for MS in three different criteria than those indexes based on body mass index, waist circumference, waist-to-height ratio and waist-to-hip ratio, even after adjusting for age and sex. In the harmonized criteria, the cut-off point of 34.2 cm.mmol/L for LAP showed the highest accuracy for MS (sensitivity 0.90, specificity 0.61, positive likelihood ratio of 2.31 and negative likelihood ratio of 0.17). Conclusions: LAP is a simple and accurate predictor tool for MS in undiagnosed adults. Moreover, it has significantly higher predictability than other screening tools commonly used to find subjects at risk of CVD and type 2 diabetes mellitus development, with the best performance at the 34.2 cm.mmol/L cut-off point. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.